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Health and Social Care Bill 2012
6. Explain the key proposals set out in the Health and Social Care Act 2012 and explore implications for public health Link to Department of Health leaflet 'Clinically-Led Comissioning' Context 1. Clinical commissioning is aimed at removing political interference and micromanagment in healthcare decisions 2. Most NHS services will be commissioned by Clinical Comissioning Groups (CCGs). GPs are expected to lead CCGs. 3. Clinical commissioning does away with practice-based comissioning and instead forms a universal system which all practices must be a part of. 4. CCGs will be regulated and supported by an NHS comissioning board Key legislative changes RESPONSIBILITY WHERE IT BELONGS - Holds Clinical Commissioning Groups (CCGs) directly responsible for comissioning services they consider appropriate to meet reasonable local needs. CORE DUTIES - The CCGs are responsible for upholding a number of core duties, including establishing choice and promoting patient involvement, and promoting innovation and research. COLLABORATION - CCGs must collaborate with each other, and with other services, to achieve overall best outcomes. FOCUS ON OUTCOMES - As long as the Mandate from the board and the Outcomes listed in the NHS Outcomes Framework are met, CCGs are welcome to achieve these goals in any way they see fit. ACCOUNTABILITY AND REASSURANCE - Ensuring an effective and comprehensive CCG system is the responsibility of the NHS Commissioning Board, FINANCIAL MANAGEMENT - The CCG budget will be determined by the Board, whose budget in turn will be determined by the Secretary of State 'Provider regulation to support Innovative Services' Context 1. The government wants to see patients accessing a range of providers who can offer services tailored to their particular needs. MONITOR 2. Monitor will regulate NHS service providers 3. Competition - Fair and effective competition is a means to give greater choice and control to patients 4. Monitor will be able to address abuses and restrictions that prevent competition and could lead to poorer care for patients. 5. Monitor will be a bespoke sector specific competition regulator for healthcare 6. Monitor will license providers, so there is not a "free for all". 7. Monitor, in conjunction with the NHS comissioning board, will regulate prices through NHS services through a national tariff. This is aimed at increasing efficiency and integration by demonstrating best practice tariffs. 8. Continuity of services - The act places a duty on Monitor to establish financial mechanisms to secure continued access to NHS services. NHS FOUNDATION TRUSTS 9. Changes ensure foundation trusts are accountable, transparent and autonomous in the way they operate. 10. Local accountability will be increased by clarifying the roles of foundation trust governors and and directors. The governors will hold the directors to account, and public board meetings will be required. 11. Foundation Trust autonomy will be increased, for example, the repeal of the private patient income cap. 'Greater Voice for Patients' CONTEXT 1. The government aims for there to be "no decision about me, without me ". 2. This will be achieved through choice and competition. 3. The government aims to build upon current Local Involvement networks (LINKs) rather than reinventing them. 4. It is important to provide a strong forum for patient feedback. Key Legislative Changes THE ACT STRENGTHENS THE COLLECTIVE VOICE OF PATIENTS - The NHS commissioning board, CCGs, Monitor, and health and wellbeing boards will all have duties with regards to involvement of patients, carers and the public. HEALTHWATCH - The Act provides for the establishment of Healthwatch England, as part of the Care Quality Comission. It will advise and provide information from patients to bodies such as the Secretary of State and Monitor. In addition, local healthwatch organisations, based in and funded by local authorities, will carry out functions currently provided by LINks. 'New Focus for Public Health' At the national level, this will be through Public Health England, which will be established as an executive agency for the Department for Health. At the Local level, this will involve putting local authorities in charge of driving health improvement, pulling together the work done by the NHS, social care, housing, environmental health, leisure and transport services. The Act abolishes the Health Protection Agency (HPA) and transfers its role to the Secretary of State. 'Greater Accountability Locally and Nationally' CONTEXT 1. The Secretary of State will remain ultimately accountable for the NHS. 2. Currently, many functions are carried out under the Minister of the day, who delegates responsibility to other organistaions. 3. Under the Act, functions will be conferred completely by Parliament onto specific organisations, limiting the Secretary of State's power to micromanage the system. 4. Ministers will continue to set, and remain accountable for, the design of the system. KEY LEGISLATIVE CHANGES THE NHS COMMISSIONING BOARD will be accountable to the Secretary of State for meeting the objectives and outcomes set out in the mandate CLINICAL COMMISSIONING GROUPS will be accountable for their decisions to the NHS commissioning board. HEALTH AND WELLBEING BOARDS are aimed at briniging together local councillors, directors of social services, children's services, public health, CCGs and patients views, through local healthwatch. Providers are more accountable to patients, who have the ability to choose their provider based on quality of services and their experiences. LOCAL HEALTHWATCH organisations will provide advice and information about access to local care services and choices available to patients and a stronger voice for patients, who will have a seat on the local health and wellbeing board. HEALTHWATCH ENGLAND will receive local healthwatch organisations' views on standards of providers' services FOUNDATION TRUST GOVERNORS roles will be strengthened and they will have a greater responsibility in holding the foundation trust directors to account. 'Streamlined arms-length Bodies' Key ideas: The Health and Social Care Act 2012 contains provisions to restructure the health and public bodies sector. The aims are to create better organisations, with greater freedom, clear duties and transparency. Secondly, to increase the proportion of money going to frontline services. The government aims to cut NHS administrative costs by a third over the next four years. KEY LEGISTLATIVE CHANGES: THE GENERAL SOCIAL CARE COUNCIL will be abolished and functions transferred to the Health Professions Council THE COUNCIL FOR HEALTHCARE REGULATORY EXCELLENCE will no longer be funded by the government, instead placing a levy on the regulators it regulates. THE OFFICE OF HEALTHCARE PROFESSIONS ADJUDICATOR will be abolished, and its role will be enfolded into the General Medical Council. NICE AND THE INFORMATION CENTRE are safeguarded, with the Act giving them greater autonomy. Various other bodies are being abolished, including the Alcohol Education and Research Council and the National Patient Safety Agency, with key functions being transferred elsewhere.